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An Alternative Approach To Sexual Function


Botanicals offer natural practitioners solutions for men’s and women’s sexual function issues.

Americans have witnessed a former politician in a television commercial for an erectile dysfunction drug, which made the subject a bit less taboo.

Unfortunately, many men and women still feel that they are alone when it comes to problems with sexual function and would rather stay silent instead of talking openly with their health care practitioner.

But they are not unique. In fact, the National Institutes of Health reported that approximately five percent of 40-year-old men and between 15 and 25 percent of 65-year-old men experience erectile dysfunction (ED) on a long-term basis. Further, according to The Mayo Clinic, as many as 40 percent of women have had hypoactive sexual desire disorder (HSDD, low sexual desire) at some point in their lives. Additionally, the Society for Women’s Health Research reported that HSDD is the most common female sexual dysfunction and it affects approximately one in 10 women.

“In looking at statistics on more serious issues, the prevalence is also surprisingly high,” said Cheryl Myers, head of scientific affairs and education for the Wisconsin-based EuroPharma Inc., parent company of the practitioner brand EuroMedica. “In a study1 of ED, rates were reported as: more than 18 percent of all men over the age of 20; among men with diabetes, that rate increased to more than 50 percent. In a Journal of the American Medical Association article from 1999, the reported rate for women was 43 percent.” 

While sexual function issues are a more common occurrence as people age, it is not the only reason men and women have problems. “Sometimes the causes come from illnesses and medications that can affect sexual functioning, like diabetes or certain drugs,” explained California-based Beverly Yates, ND. “Drugs that can negatively affect sexual health include antidepressants, antihypertensives, antihistamines and decongestants. For women, physical causes of sexual health problems include diabetes, heart disease, hormone imbalances, neurological diseases and alcoholism.
Psychological causes of sexual health problems in women include stress, anxiety, depression, past traumatic experiences and relationship problems, such as resentment. For men, physical causes and psychological causes of sexual health problems are very similar to women’s.” 

Sexual dysfunction for men includes a number of problems including a lack of libido, low testosterone, andropause and ED.Women can also experience a lack of libido in addition to anorgasmia, vaginal dryness, as well as dealing with the hormonal changes that come with menopause and pregnancy and breastfeeding.

Botanical Options 

While prescription drugs may have been the first choice, many people are switching to more natural alternatives after a bad experience. “Pharmaceuticals may have undesirable side effects, or are contraindicated in some cases, driving patients to seek natural alternatives,” said David Winston, RH (ACG), dean of David Winston’s Center for Herbal Studies, founder of the Herbal Therapeutics Research Library and president of the New Jerseybased Herbalist & Alchemist. “And there is a segment of the population that looks to natural alternatives first, before going the allopathic medicine route.” 

“Botanical agents have traditionally been used for many years and in numerous cultures to promote increased sexual desire and improved sexual performance, including improved male erections, female libido enhancement and orgasm in both sexes,” added Dr. Yates. “For one example, tribulus, a botanical agent, is used to promote improved male libido, stamina and fertility. Another example, maca, is an herb that is used to promote improved fertility and better stress response, as stress can disrupt numerous aspects of sexual health. A final example, damiana, is used to increase libido, especially in women, and as an aphrodisiac for both sexes.” 

Other widely used botanicals include: 


Maca (Lepedium meyenii), a root that grows in the Andes highlands is used in natural medicine for stamina, energy and sexual function for both women and men.“Maca has been used as an aphrodiasiac in Peru for 5,000 years,” said Tori Hudson, ND, medical director for A Woman’s Time and clinical professor at the National College of Natural Medicine/Bastyr University and Southwest College of Naturopathic Medicine. “Alkaloids from the root of the plant act upon the two key glands in the brain, the hypothalamus and the pituitary, supporting and boosting energy levels and encouraging the production of ovarian hormones, such as estrogen and testosterone.” 

Andes Organic Maca from EuroPharma is certified organic, highly concentrated and offers a significant quantity of pure maca extract in capsules. Additionally, it is sustainably harvested and purchased at fair prices to benefit the indigenous people of the Andes who grow this highly medicinal botanical, according to the company.

North Carolina-based Gaia Herbs also includes maca in its products to support sexual health. “Gaia Herbs Professional Solutions offers two all-herbal products aimed specifically at supporting sexual health: Libido-F for women and Libido-M for men. Libido-F contains tribulus, wild oats milky seed, horny goat weed, damiana, maca, blue vervain and sarsaparilla,” said Tammy McIver-Gay, director of business development for Gaia Herbs. “Libido-M contains many of these same botanicals, plus muira puama, yohimbe, fo-ti root and saw palmetto. These products are offered in our patented, exclusive liquid phyto-cap delivery form.” 


Used in ayurvedic medicine for approximately 3,000 years, ashwagandha (Withania somnifera) is a plant found in India that is traditionally used for anxiety, ED, a lack of libido in men and menstrual cramps in women.

“Research at the University of Texas Science Center suggests that ashwagandha acts much like GABA, a brain chemical that promotes relaxation,” said Dr. Hudson. “Another way to improve sexual response is to improve the circulation in the pelvic area. This ayurvedic herb stimulates the formation of nitric oxide and acetycholine, both important in dilating blood vessels in genital organs. While ashwagandha is commonly used more for menstrual cramps and rheumatic disorders, its action as a circulatory stimulant warrants consideration.” 

In addition to ashwagandha root, David Winston’s Gentle-Man product contains oat milky seed (Avena sativa), black cohosh root (Actaea racemosa), mimosa bark (Albizia julibrissin), saw palmetto berry (Serenoa repens), pulsatilla herb (Pulsatilla vulgaris) and orange flavoring.

Sea Buckthorn

Sea buckthorn berries and oil extract contain omega-7 fatty acids, which are helpful in relieving dryness and irritation of mucous membranes. According to EuroPharma’s Myers, in regards to sexual function, alleviating vaginal dryness and irritation contributes significantly to comfortable and more pleasurable sexual experiences in women who are troubled by this concern. “Our EuroMedica product is called ProHydra- 7 and it contains the dosages of sea buckthorn berry and seed oil used in clinical trials for significant effects,” she said, adding that it is necessary to use the product for a minimum of eight to 12 weeks for optimal results.

Natural Lubricants 

For postmenopausal women, many sexual problems are related to a loss of estrogen in the genitals, including a lack of adequate lubrication with sexual arousal, according to Dr. Hudson. This can lead to “bleeding and pain with sexual activity,” she explained. “Vaginal dryness is associated not only with painful vaginal sex, but also with a decrease in sexual desire.With a loss of estrogen, relaxation of vaginal tissue and decreased muscle tone can lead to a decrease in sexual response.” 

Dr. Hudson noted that lubrication during sex may be necessary for some women’s sexual function and comfort, and that natural lubricants are less irritating than ones that utilize synthetic chemicals. “Vitamin E oil can be used as a lubricant, while water-based products containing vitamin E oil and allantoin are nondrying and nonirritating,” she said. “Ingredients to look for in oil-based lubricants include glycerin, yerba santa and castor oil. Numerous topical products with botanicals and nutrients can enhance female arousal and orgasm. For example, a randomized, doubleblinded, crossover study evaluating a product (containing borage seed oil, evening primrose oil, extracts of angelica and coleus, along several antioxidants) in women who had been diagnosed with female sexual arousal disorder found it increased sexual pleasure in more than 90 percent of them.” 

Creating An Open Forum 

As Baby Boomers age, the number of sexual function issue will become more common. “This is likely to be an area of increasing concern to the patients of practitioners as the population ages and more people, for a variety of reasons, shy away from pharmaceutical treatments,” explained Winston. “The tools available in conventional medicine are fairly limited, whereas a natural health practitioner has so many more treatments to utilize.” 

And in order to feel comfortable speaking about sexual function problems, some patients may need a nudge. As some will not come right out and ask their health practitioner a question about their concerns, they may be more likely to answer one. “Ask your patient directly if she/he is satisfied with their sex life, with their sexual performance and their own level of sexual satisfaction,” said Dr. Yates. “In a medical or health care setting, patients are rarely asked about their sexual health. Listen respectfully and carefully to their answer, as you may learn how else you can better serve the person who is seeking your advice and support.” 

“The category of sexual health is probably an underdeveloped category, for the reasons stated by Dr. Yates,” said Gaia Herbs’McIver-Gay. “Many patients are reluctant to talk to their health care provider about sexual health issues and many providers do not make this a part of their regular discussions with patients.While sexual issues are fairly prominent, treatments (including supplements) remain underutilized because this topic is not often part of a patient’s annual health exam and discussion.” 


1 Selvin E, Burnett AL, Platz EA. “Prevalence and risk factors for erectile dysfunction in the US.” Am J Med. 2007 Feb;120(2):151-7.

Healthy Take Aways

Approximately five percent of 40- year-old men and between 15 percent and 25 percent of 65-year-old men experience erectile dysfunction (ED) on a long-term basis.

Hypoactive sexual desire disorder (HSDD) is the most common female sexual dysfunction and it affects approximately one in 10 women.

Maca (Lepedium meyenii), a root that grows in the Andes highlands, is used in natural medicine for stamina, energy and sexual function for both women and men.

Many sexual problems for postmenopausal women are related to a loss of estrogen in the genitals, including a lack of adequate lubrication with sexual arousal.

Be direct with patients and try to make them feel comfortable to speak honestly about their worries. Many patients are afraid to voice their concerns, but by creating an environment where they feel safe may give them the push they need to be honest.